The Luo Council of Elders (LCE) has said no to forced circumcision as one of the ways of containing the spread of HIV/Aids.

LCE Chairman, Mr Riaga Ogalo, and deputy secretary, Mr Adera Osawa, said they would not allow the erosion of their culture on the basis of controversial studies.

"We cannot force our male members to undergo the cut, which has not been a part of our culture, to please scientists," Ogalo said.

The World Health Organisation on Wednesday announced that circumcision be part of HIV prevention package.

Trials carried out in Kenya showed that male circumcision reduces likelihood of contracting HIV by about 60 per cent. Similar results were found in Uganda and South Africa.

"Let them preach behavioural change, which we started as elders in 1999, than releasing findings of controversial studies," Osawa said. About 30 million people in Africa are believed to be HIV positive and more than 90 per cent of HIV infections in African adults result from unprotected sex.

The elders however, said men may undergo the cut but on their own volition. "We have not disowned members of the Nomiya Luo Church from the community because they have undergone the cut," observed Ogalo.

Nyanza has the highest number of reported HIV/Aids cases and a prevalence rate of 14 per cent with more females affected than males.

Circumcision may reduce men's chances of contracting HIV by up to 60 per cent, but early results suggest the procedure may put women at increased risk of infection.

[NB: "up to 60 per cent" - like "up to 60 per cent" off at a sale - but just try to find the wonderful bargains...]

Preliminary data presented at a U.N. consultation in Switzerland on Tuesday on the potential impact of male circumcision on AIDS in Africa suggested that if HIV-positive men do not abstain from sex while healing from circumcision surgery, their female partners might have a higher chance of catching HIV from them.

'We need to erron the side of cautionto protect womenin any futuremale circumcisionprogram.

—Dr. Maria Wawer,lead investigatorof study

However, experts said the results were not conclusive — and highly susceptible to other factors, such as condom use — demonstrating the difficulties of utilizing circumcision in HIV prevention in sub-Saharan Africa, where more than 60 per cent of those with AIDS are women.

Previous studies have confirmed the dramatic impact circumcision has in cutting men's HIV infection rates, but a big question has been the resulting effect on women.

The first evidence — though very preliminary — suggests there is a period immediately following surgery when men may more easily transmit the virus to their female partners.

"Women are already so vulnerable in this epidemic," said Jennifer Kates, an AIDS expert at the Kaiser Family Foundation who is not connected to the study. "We need to be particularly careful about anything that could put them at even greater risk."

Researchers at the Rakai Health Sciences Program and Makerere University in Uganda and the John Hopkins Bloomberg School of Public Health in the U.S. tracked 997 HIV-positive men in Uganda and their female partners.

Among 70 men with HIV who underwent circumcision, 11 of their female partners became infected with the virus in the month after the surgery. In contrast, only four partners of 54 uncircumcised men with HIV in the control group caught the virus — nearly half the rate, early results showed. [That's 15.7% compared to 7.4% - much greater than the percentages - circumcised or intact - infected in the circumcision trials over 24 months.]

Researchers said the results suggest increased HIV transmission from men who have sex before they had properly healed.

However, they said the numbers so far were too small to be statistically significant, and left open the possibility that the higher rates were due to chance; both groups of men and women were given repeated HIV prevention education and free condoms. [- as they were in the circumcision trials]

Protecting womenExperts said the study showed the importance of finding ways to protect women in the search for ways to fight AIDS.

"We need to err on the side of caution to protect women in any future male circumcision program," said Dr. Maria Wawer, the study's lead investigator, a researcher at Johns Hopkins Bloomberg School of Public Health.

More than 60 per cent of AIDS patients in sub-Saharan Africa are women. The social and economic inequalities between men and women are thought to be responsible for the elevated rates of infection in women, with many women trapped in relationships with unfaithful men.

The preliminary results do not call into question the utility of circumcision as a way to prevent AIDS in Africa.

[Huh? They sure do! They may not contradict a negative correlation between the state of being circumcised and healed and HIV transmission, but that's a different story. Imagine if condoms were found to be associated with HIV transmission, whether that would "call into question" their utility.]

But "while male circumcision has extraordinary potential to prevent HIV infection, these new findings remind us that we must proceed with thought and care in developing strategies to expand male circumcision in Africa," said Dr. Kevin De Cock, director of WHO's AIDS department. "Circumcision is an additional prevention strategy rather than a replacement for anything else."

PARIS, March 6, 2007 (AFP) - Early data from a trial in Uganda shows that policymakers must be prudent when including circumcision among their tactics for fighting AIDS, researchers said on Tuesday.

Last year, three groundbreaking studies conducted in Africa found that male circumcision halved a man's risk of being infected by the human immunodeficiency virus (HIV).

That discovery ignited hopes that the flagging quarter-century-old war against AIDS in Africa could be transformed by a simple, low-cost operation.

The new trial, funded by the Bill and Melinda Gates Foundation, explores a different angle of the circumcision story -- to see whether men who are infected with HIV and are circumcised are any less likely to infect their female partner.

US and Ugandan researchers are following 997 HIV-infected men in Rakai, Uganda. Some of them have been given circumcision, while the others have remained uncircumcised to act as a comparison.

A proportion of volunteers in both groups had uninfected long-term female partners at the start of the study. These women were also enrolled and monitored.

A review at the study's six-month mark looked at 70 couples in the "circumcised" group and found that 11 of the women had become infected. Among 54 couples in the "uncircumcised" group, four women had become infected.

The study is still underway and the data is not considered conclusive.

But the researchers said they were concerned, as several of the infections had been transmitted by men who had had sex before their wounds had fully healed from the circumcision surgery.

The AIDS virus can be carried in the blood, as well as in semen. [much more in blood than in semen]

This means that, before circumcision can be universally endorsed as a prevention strategy, men and women have to be fully aware about the need to refrain from intercourse for a month or so while the penile wound has healed, the researchers said.

Both partners must be fully versed in safe-sex awareness, especially in condom use.

"We need to err on the side of caution to protect women in the context of any future male circumcision programme," said the study's lead scientist, Maria Wawer of the Johns Hopkins Bloomberg School of Public Health.

"Women make up a majority of people living with HIV in Africa, and these results demonstrate that women need to be educated about the risks and benefits of male circumcision," she said in a press release.

If the finding about infection from post-operative wounds is taken into account, the trial found that there was no protection to partners of HIV-infected, circumcised men within the first six months of surgery.

The next step is to see whether that picture changes over the longer term.

The data was released on Tuesday as a contribution to a meeting in Montreux, Switzerland, gathering the UN's World Health Organisation (WHO) and UNAIDS.

The two agencies are mulling the outcome of the three big trials to weigh how far, and how fast, they should endorse circumcision as a prevention policy.

WHO expert Kevin De Cock stressed the need for caution and good preparations.

"While male circumcision has extraordinary potential to prevent HIV infection, these new findings remind us that we must proceed with thought and care in developing male circumcision in Africa," said De Cock.

Volunteers in the Rakai study were repeatedly given safe-sex counselling and provided with free condoms. Women who become infected have been promised access to free HIV care and antiretroviral drugs.

MONDAY, March 5 (HealthDay News) -- Researchers have discovered that cells in the mucosal lining of human genitalia produce a protein that "eats up" invading HIV -- possibly keeping the spread of the AIDS more contained than it might otherwise be.

Even more important, enhancing the activity of this protein, called Langerin, could be a potent new way to curtail the transmission of the virus that causes AIDS, the Dutch scientists added.

Langerin is produced by Langerhans cells, which form a web-like network in skin and mucosa. This network is one of the first structures HIV confronts as it attempts to infect its host.

These are the same Langerhans cellsthat have been demonised for years- especially by the cirumcision lobby -for "inviting HIV into the body", and of courseneeding to be removed by male circumcision.

However, "we observed that Langerin is able to scavenge viruses from the surrounding environment, thereby preventing infection," said lead researcher Teunis Geijtenbeek, an immunologist researcher at Vrije University Medical Center in Amsterdam.

"And since generally all tissues on the outside of our bodies have Langerhans cells, we think that the human body is equipped with an antiviral defense mechanism, destroying incoming viruses," Geijtenbeek said.

The finding, reported in the March 4 online issue of Nature Medicine, "is very interesting and unexpected," said Dr. Jeffrey Laurence, director of the Laboratory for AIDS Virus Research at the Weill Cornell Medical College, in New York City. "It may explain part of the relative inefficiency of HIV in being transmitted."

Even though HIV has killed an estimated 22 million people since it was first recognized more than 25 years ago, it is actually not very good at infecting humans, relatively speaking.

For example, the human papillomavirus (HPV), which causes cervical cancer, is nearly 100 percent infectious, Laurence noted. That means that every encounter with the sexually transmitted virus will end in infection.

"On the other hand, during one episode of penile-vaginal intercourse with an HIV-infected partner, the chance that you are going to get HIV is somewhere between one in 100 and one in 200," Laurence said. [- greater chance if you are the woman]

Experts have long puzzled why HIV is relatively tough to contract, compared to other pathogens. The Dutch study, conducted in the laboratory using Langerhans cells from 13 human donors, may explain why.

When HIV comes in contact with genital mucosa, its ultimate target -- the cells it seeks to hijack and destroy -- are immune system T-cells. But T-cells are relatively far away (in lymph tissues), so HIV uses nearby Langerhans cells as "vehicles" to migrate to T-cells.

For decades, the common wisdom was that HIV easily enters and infects Langerhans cells. Geijtenbeek's team has now cast doubt on that notion.

This "common wisdom" relies almost entirelyon one in vitro (in glassware) experimentby Szabo and Short using penile tissuefrom the cadavers of 13 men aged 60-90.Their bias towards circumcisionwas evident from the outset.

Looking closely at the interaction of HIV and Langerhans cells, they found that the cells "do not become infected by HIV-1, because the cells have the protein Langerin on their cell surface," Geijtenbeek said. "Langerin captures HIV-1 very efficiently, and this Langerin-bound HIV-1 is taken up (a bit like eating) by the Langerhans cells and destroyed."

In essence, Geijtenbeek said, "Langerhans cells act more like a virus vacuum cleaner."

Only in certain circumstances -- such as when levels of invading HIV are very high, or if Langerin activity is particularly weak -- are Langerhans cells overwhelmed by the virus and infected.

Levels of invading HIV are very highimmediately after a person has been infected.That is why a campaign for "zero grazing"(longer-term relationships)has worked so well in Uganda.(The HIV infection rate among the intact menin the Uganda experiment was lowerthan that among the circumcised menin the Kenya experiment.)

The finding is exciting for many reasons, not the least of which is its potential for HIV prevention, Geijtenbeek said.

"We are currently investigating whether we can enhance Langerin function by increasing the amount of Langerin on the cell surface of Langerhans cells," he said. "This might be a real possibility, but it will take time. I am also confident that other researchers will now also start exploring this possibility."

The discovery might also help explain differences in vulnerability to HIV infection among people.

"It is known that the Langerin gene is different in some individuals," Geijtenbeek noted. "These differences could affect the function of Langerin. Thus, Langerhans cells with a less functional Langerin might be more susceptible to HIV-1, and these individuals are more prone to infection. We are currently investigating this."

The finding should also impact the race to find topical microbicides that might protect women against HIV infection. Choosing compounds that allow Langerin to continue to work its magic will enhance any candidate microbicide's effectiveness, the Dutch researcher said.

Laurence did offer one note of caution, however.

"In the test tube, this is a very important finding," he said. "But there are many things in the test tube that don't occur when you get into an animal or a human. Having said that, though, this is a very intriguing finding."

afrol News, 26 February - New research dramatically contradicts the popular conclusions of recently published reports, holding that male circumcision protects against contracting AIDS. Scientists looking at male circumcision and female genital mutilation (FGM) practices in Kenya, Lesotho and Tanzania found that the cut in itself was causing many new AIDS cases among adolescents.

The research, published in the March issue of the scientific journal 'Annals of Epidemiology', was carried out by a team of researchers led by Devon Brewer, director of the research firm Interdisciplinary Scientific Research. "We found that circumcised virgins and adolescents in Kenya, Lesotho, and Tanzania were consistently and substantially more likely to be infected with HIV than their uncircumcised counterparts," Mr Brewer said.

The researchers analysed data from the 'Demographic and Health Surveys', which are based on nationally representative samples of adolescents and adults. In the three African countries studied, circumcision is typically performed in adolescence or early adulthood and often in unhygienic circumstances where many individuals are circumcised with shared, unsterilised cutting instruments.

"Sexually experienced male adolescents were no more likely to be infected than adolescent virgins, further highlighting how HIV may be spreading by means other than sex," the researchers concluded.

Mr Brewer said "a key problem with nearly all prior research on circumcision in Africa is that researchers have treated circumcision only as an anatomic characteristic, and not also as a potential exposure to others' blood during the circumcision operation." He continued, "this is striking, because over the last 20 years, many Africans, including children, have warned that HIV can spread through circumcision procedures."

The new results in particular raise questions about how to understand the recent randomised trials of male circumcision in South Africa, Kenya, and Uganda. These studies, in which some uncircumcised men were randomly assigned to be circumcised in presumably sterile conditions and others were not circumcised, showed that male circumcision reduced HIV acquisition.

The popular news reporting of these findings has been widespread in Africa. And the basic message in African media has been that circumcising young boys - and sometimes girls - will protect them from contracting HIV-AIDS. The new study however shows that this conclusion is not only wrong, but also a dangerous message, due to the poor hygienic standards normally applied at circumcision ceremonies.

Mr Brewer said, "If we had known several years ago what we know now from the national surveys, there would not have been a good empirical basis even to conduct the trials. Therefore, it is crucial to investigate thoroughly the possible mechanisms - which are speculative at this point - for the protective effect observed in the trials."

The US researcher and his colleagues finally called for more intensive study of HIV transmission in the context of both traditional and medical circumcision in sub-Saharan Africa.

He was taken to hospital but died eight days later. A post mortem found the infant died from cardiac arrest and oxygen starvation.

Police are to interview family members and the senior rabbi who performed the operation at Golders Green Synagogue in North London. Concerns raised by doctors treating the baby have led to the probe being led by Scotland Yard's child abuse investigators.

Police and Home Office sources said the investigation was "highly unusual".

A Scotland Yard spokesman stated: "The death is being treated as unexplained at this early stage."

The baby died two weeks ago at University College Hospital, Central London.

Circumcision of boys is an operation in which the foreskin is removed from the penis. With small babies, local anaesthetic is often sufficient and avoids the risks of a general anaesthetic.

[And the relevance of this is...? At a Brit Milah the only painkiller is usually a sop of sugar or wine.]

Some people believe the skin is redundant and gets in the way of hygiene.

Others say it is a vital part of the male anatomy and should not be removed.

Judaism considers circumcision to be an important ritual. The operation is usually performed by a mohel - a specialist in the procedure and its rituals.

Many British mohels are doctors, rabbis or both. All have received appropriate medical and religious training.

A spokesman for The United Synagogue, a membership of 35 orthodox synagogues in Greater London, said: "We are awaiting the results of the police enquiry and until then it would not be appropriate for us to comment further."

[This case is almost unique in that no other cause than circumcision itself has been given for the death - not haemorrhage, infection nor complications of anaesthetic, just the shock of the operation.]

POLICE are investigating the death of a baby boy who suffered a cardiac arrest after he stopped breathing at a synagogue.

The eight-day-old baby, who had reportedly just been circumcised, was taken to hospital after he suddenly developed breathing problems at a synagogue in Golders Green, north west London, the Metropolitan Police said.

A police spokesman said he was taken to the Royal Free Hospital by the Hatzola Ambulance Service at about 8.25am on February 1.

He was later transferred to University College Hospital, where he died on February 9. A post-mortem examination found the baby suffered a cardiac arrest and oxygen starvation to the brain. The cause of death has not been confirmed and police are treating the death as unexplained, the spokesman said.

A spokesman for the Board of Deputies of British Jews named the boy as Amitai. He said: "We are deeply saddened by the event. There were absolutely no problems at the time of the circumcision and it was about 15 minutes afterwards that it was noticed there were some breathing difficulties."

[15 minutes? Obviously no connection at all! The baby lived in good health for seven days, and just happened to have fatal diffculty 15 minutes after a sharp knife was taken to his penis.]

A bizarre incident at Meru South¹s Kiriani Boys High is a clear sign of a school administration¹ s dereliction of duty.

The principal sent home 20 Form One students to be circumcised three
days after they joined the school. In letters the boys carried home to
their parents, the principal instructed that they undergo the rite and
return to school after two weeks.

To the principal, the students could not fit in the school "in the
condition they are in". He further accuses parents of sneaking their sons into the
school without disclosing that the boys were "not done".

His argument that the uncircumcised boys would make circumcised ones
uncomfortable or lead to indiscipline has no professional grounding and
is the logic of a fanatic, someone who should be kept far away from children -
all children.

When the students joined the school, they must have met all the
conditions of admission. But they have now been discriminated against for a cultural practice that has nothing to do with their being in school.

We cannot help but wonder how the school found out that the students
were not circumcised. Were they stripped naked for the school administration to
find out? This would be a clear violation of their rights. Or were they
called, one by one, to confess whether they were circumcised? When the principal accuses parents of 'sneaking' their sons into the school without disclosure, does he suggest that it was a requirement for joining the institution?

If the administrator' s concern was that the boys' condition would cause
indiscipline, then he failed in his cardinal role to protect the children under him from bullying. The vice still manifests itself in schools, especially when new students report, and it is the responsibility of the school to fight it, not give in to bullies. This is what the principal has done.

It is not the Form One students who should be at home; it is those who
would have [made] their life difficult simply because they have [not] 'faced the
knife'.

The Teachers Service Commission must discipline the principal for he has
proven that he is irresponsible and unfit to hold the position.

NYERI, Kenya, Feb 13 (Reuters) - A Kenyan secondary school sent 20 boys home to protect them from being bullied because they were uncircumcised, the school's principal said on Tuesday.

Most of Kenya's ethnic groups carry out the practice as a transition from boyhood to manhood and consider those who are not circumcised to be "lesser men".

"The 20 boys were being subjected to bullying and all other kinds of mistreatment for not being circumcised," Fredrick Kithinji, the head of Kiriani Boys High School in Meru central Kenya, told Reuters by telephone.

"It is taboo among the Meru community for a boy to join secondary school before undergoing the operation," he added.

[And do other communities have to obey the Meru's taboos?]

The age of the boys sent home from school was not immediately available, but form one boys are usually 14 or 15 years old.

Kithinji said the boys, who had just joined the school, were free to return once they had undergone the procedure and were healed.

But many parents reacted angrily to the order saying it was the administration's responsibility to protect their children from older boys.

"It was not written anywhere in the admission form that a boy has to be circumcised first before joining the school," said Gitonga Muthamia, a parent to one of the boys sent home.

WASHINGTON (Reuters) -- People who use large amounts of skin-numbing
creams and lotions, often in conjunction with cosmetic procedures, are at
risk of irregular heartbeats, seizures and even death, U.S. health
officials warned Tuesday.

The Food and Drug Administration, citing two deaths, said such
topical anesthetics can be applied in amounts so large that a lethal dose
of the chemicals can enter the bloodstream.

A 22-year-old woman and a 25-year-old woman who applied numbing
creams after laser hair removal on their legs later died, the agency said

After the procedure, "these women then wrapped their legs in plastic
wrap, as they were instructed, to increase the creams' numbing effect.
Both women had seizures, fell into comas, and subsequently died from the
toxic effects of the anesthetic drugs," the FDA said.

Numbing creams and lotions, available both by prescription and over the
counter, are approved to soothe ... pain
before, during and after various procedures. They contain numbing drugs
that can include lidocaine, tetracaine, benzocaine and prilocaine.

[Lidocaine and prilocaine are the drugs used in EMLA for circumcision, despite the risk of methmeoglobinemia.]

But the FDA said consumers should be cautious about using them
without medical supervision.

... Small children and people with heart or severe liver disease are also at higher risk.

People considering skin-related cosmetic or medical procedures should
talk to their doctors about whether they need numbing creams, the agency
said. ...

"You should also discuss with your doctor whether there are other
ways to reduce the pain you may feel during the procedure," it added.

[A way that has univerally been found to reduce the pain of infant circumsion by 100% is, not to do it.]

UNITED NATIONS (Reuters) - More parents are turning to medical clinics to perform genital mutilation, wrongly assuming that it spares girls physical and psychological damage, a U.N. agency warned on Monday.

The trend has been spotted in Egypt, Kenya, Somalia, Djibouti and Yemen,
according to demographic surveys and patient reports, the U.N. Population Fund said.

"This tendency arises from increased awareness of the health risks
associated with the practice," said Thoraya Ahmed Obaid, the fund's executive director.

The practice, also known as female circumcision, usually involves cutting
of the clitoris and other parts of the female genitalia. Many practitioners are untrained and use crude instruments. The practice leaves lasting physical and psychological scars, in addition to the risks it generates during childbirth, the U.N. Population Fund said.

Some 3 million girls face the risk of circumcision every year, Obaid said.
An estimated 120 million to 140 million women and girls have been subjected to the cutting.

Immediate complications include severe pain, shock, hemorrhage, urine
retention, ulceration of the genital region and injury to adjacent tissue. Hemorrhage and infection can cause death, the World Health Organization said.

Obaid also warned that in some nations parents were subjecting "younger
and younger" girls to the practice to avoid refusals to participate. Girls generally undergo the rite before the age of 10, often without anesthesia.

While predominant in 28 African countries, including Sudan, Chad, Sierra
Leone and Djibouti, genital mutilation also takes place in some Middle East nations, such as Saudi Arabia, and among immigrant communities in Europe and North America.

[This was predicted, in a press-release issued by the Ninth International Symposium on Genital Integrity in Seattle in August 2006, as a consequence of attempts to popularise "medical" circumcision of males.

All the consequences mentioned are risks of male circumcision also. Medicalised FGM will make it much more comparable with medicalised male circumcision, yet activists continue to insist they are different.]

Last Updated: Monday, January 22, 2007 | 12:27 PM AT
About one in three healthy baby boys is circumcised on Prince Edward Island, about double the national rate, despite the advice of experts who describe it as unnecessary and potentially risky.

'If you're coming at it from that perspective, I can give you a lot of procedures that are not medically necessary.'— Dr. Doug Tweel

[So don't do them either. And none are

On newborns

On one sex only

Removing healthy, non-renewable tissue

At parental whim

]

Dr. Peter Anderson, a pediatric urologist at the IWK Health Centre in Halifax said the procedure is most often performed because other family members are circumcised. Anderson said complications from the procedure can be severe.

"If you can think of a complication it almost certainly has happened somewhere in the world," he said, "right from the minor thing of a little bit of extra bleeding to the extreme disaster of loss of the penis."

Nova Scotia's circumcision rate is close to the lowest in Canada, just over one per cent. Anderson believes that's because the procedure is not offered at hospitals.

On P.E.I., the operation is performed at the Queen Elizabeth Hospital in Charlottetown. In December some Island doctors tried to have circumcision banned there, because it is not medically necessary. The issue went to a vote, and the procedures will continue.

Dr. Doug Tweel is one of the few Island doctors who perform circumcisions.

"There are many procedures done in the hospital setting that are elective procedures," said Tweel.

"If you're coming at it from that perspective, I can give you a lot of procedures that are not medically necessary."

The procedure is not covered by medicare. P.E.I. doctors charge about $50 dollars. In Nova Scotia the charge is close to $300.